FAQs

What is a Pap test?
A Pap test is a microscopic examination of cells taken from the cervix done in a doctor’s office or health clinic. This test is a screening tool for cervical cancer which, through Pap tests and treatment where necessary, is preventable. Click here for more information about Pap tests[1].

What if my doctor told me I don’t need one?
The Ontario Cervical Screening guidelines state that people who have sex with women should follow the same cervical screening guidelines as people who have sex with men. If you have ever in your life had any kind of sexual activity with anyone that involved the genital area, you need, and have a right to, a Pap test.

What if I’m on testosterone?
There is currently no evidence that testosterone either increases or decreases our risk of cervical cancer. However, we do know that testosterone causes changes to cervical cells that look like (or mimic) cervical dysplasia (pre-cancerous changes). If you are taking ‘T’, your doctor should note this on the lab forms.

What do abnormal results mean if I’m on T?
Abnormal results do NOT mean you have cancer. If you are taking testosterone, abnormal results may be because of changes to the cervix caused by ‘T’. However, your doctor will probably want to make sure things are alright, usually with additional pap tests and possibly a colposcopy [3](click for more info).

Is the Pap test an STI test?
The Pap test is not a screening test for sexually transmitted infections (STIs). While the Pap test may show that cells of the cervix have been affected by HPV, the STI that can lead to cervical cancer, it does not actually test specifically for HPV.

Does a Pap test hurt?
Technically speaking, pap tests can causes mild discomfort but they shouldn’t hurt or cause significant pain. However, some trans men report that they are painful. For trans men who don’t engage in frontal sex or find it traumatic, penetration of any kind can be difficult and painful. This may also be the case if you have experienced pelvic trauma or survived abuse. Some also report that dryness caused by testosterone can make pap tests painful. Click here for tips on how to make it easier for you[4].

What if I have a disability?
If you have a cervix and have ever been sexually active, you need regular paps- regardless of ability. However, unfortunately not all healthcare settings are accessible for clients with disabilities. When you book an appointment for Pap it’s a good idea to tell the provider what you’ll need (i.e. adjustable bed, help with transferring, sign language interpretation).

What if I have an ‘M’ on my OHIP card?
Some trans men who have cervixes may have the sex on their health card listed as ‘male’ (M). If this is the case, you still need and are entitled to pap tests. Your doctor or nurse will need to note that you are a trans man on the lab forms so that there isn’t confusion at the laboratory.

Do trans men get tested differently?
A pap test is the same for anyone who has a cervix. If you have had a hysterectomy, you may have a ‘vault’ or ‘cuff’ smear, which tests the cells inside your front hole for HPV-related abnormalities. However, the results of your pap test may need to be interpreted differently if you are on testosterone. You should tell your healthcare provider that you are on ‘T’, and they should note this on the lab forms.

Are there alternatives to a pap test?
For many of us, pap tests are extremely uncomfortable or even traumatic. Remember that there are some steps we and our healthcare providers can take to make the experience better (see ‘Tips for Getting a Pap’). A pap test is the only way to know if HPV is causing pre-cancerous changes in the cervix.

Can I get a hysterectomy to avoid paps?
Some trans men choose to have a hysterectomy to avoid pap tests. Remember that unless your cervix is removed, you still need regular pap tests. If your cervix is removed, your doctor still may recommend at least one ‘vault’ or ‘cuff’ smear, especially if you have a history of abnormal paps or cervical dysplasia.